scholarly journals FEATURES OF GLYCEMIA INDICES DYNAMICS IN THE COURSE OF SURGICAL TREATMENT OF PATIENTS WITH LOCAL WOUNDS AND DIABETES MELLITUS

2016 ◽  
pp. 53-59
Author(s):  
I. A. Slavnikov ◽  
Z. A. Dundarov
Keyword(s):  
Diabetes Mellitus ◽  
Surgical Treatment ◽  
Carbohydrate Metabolism ◽  
Conservative Therapy ◽  
Impaired Glucose Metabolism ◽  
Antihyperglycemic Therapy ◽  
Different Types ◽  
Patients With Diabetes ◽  
Long Acting ◽  
Persistent Hyperglycemia

Objective: to determine regularities of the dynamics of carbohydrate metabolism indices in the application of various techniques of the treatment for local wounds in patients with diabetes mellitus. Material and methods. We studied the glycemia dynamics in 83 patients with different types and duration of diabetes mellitus who had local wounds of various genesis and limitation period. We applied various ways of conservative therapy and surgical treatment of wound defects and also their combinations in the out-patient conditions of hospital. Hypocarbohydrate diet, various schemes of insulin therapy with short and long acting preparations, oral application of antihyperglycemic preparations of biguanide and sulfonylurea groups, and also their combination were applied as antihyperglycemic therapy. Results. Elimination of local wound defects with a small amount of necrotic mass or its absence in patients with different types of diabetes mellitus by means of various conservative techniques and operative treatment leads to the decrease of prandial glucose concentration in capillary blood. Patients with significant volume of wound detritus did not reveal such a relation. Conclusion. Necrotizing tissues in the area of a local wound defect in patients with impaired glucose metabolism are the cause of persistent hyperglycemia in these patients. This is an unfavorable factor for medicinal compensation of carbohydrate metabolism.

scholarly journals Impaired glucose metabolism in patients with diabetes, prediabetes and obesity is associated with severe Covid-19

2020 ◽  
Author(s):  
Stephen M. Smith ◽  
Avinash Boppana ◽  
Julie A. Traupman ◽  
Enrique Unson ◽  
Daniel A. Maddock ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Glucose Metabolism ◽  
Clinical Characteristics ◽  
Severe Disease ◽  
Impaired Glucose Metabolism ◽  
Disease Pathogenesis ◽  
Patients With Diabetes ◽  
Persistent Hyperglycemia ◽  
Hba1c Levels

AbstractBackgroundIdentification of risk factors of severe Covid-19 is critical for improving therapies and understanding SARS-CoV-2 pathogenesis.MethodsWe analyzed 184 patients hospitalized for Covid-19 in Livingston, New Jersey for clinical characteristics associated with severe disease.ResultsThe majority of Covid-19 patients had diabetes mellitus (DM) (62.0%), Pre-DM (23.9%) with elevated FBG, or a BMI > 30 with normal HbA1C (4.3%). SARS-CoV-2 infection was associated with new and persistent hyperglycemia in 29 patients, including several with normal HbA1C levels. Forty-four patients required intubation, which occurred significantly more often in patients with DM as compared to non-diabetics.ConclusionsSevere Covid-19 occurs in the presence of impaired glucose metabolism in patients with SARS-CoV-2 infection. The association of dysregulated glucose metabolism and severe Covid-19 suggests a previously unrecognized manifestation of primary SARS-CoV-2 infection. Exploration of pathways by which SARS-CoV-2 impacts glucose metabolism is critical for understanding disease pathogenesis and developing therapies.

scholarly journals Prediabetes: challenges and opportunities

2021 ◽  
pp. 220-227
Author(s):  
T. B. Morgunova ◽  
I. V. Glinkina ◽  
V. V. Fadeev
Keyword(s):  
Diabetes Mellitus ◽  
Carbohydrate Metabolism ◽  
Lifestyle Modification ◽  
Risk Group ◽  
Lifestyle Changes ◽  
Moderate Intensity ◽  
Number Of Patients ◽  
Antihyperglycemic Therapy ◽  
The World ◽  
Patients With Diabetes

In the world, the number of patients with carbohydrate metabolism disorders is steadily growing. Over the past 10 years, the number of patients with diabetes mellitus in the world has more than doubled. Moreover, there is not only an increase in the number of patients with diabetes mellitus, predominantly type 2 diabetes, but also with prediabetes. The term «prediabetes» means impaired glucose tolerance and impaired fasting glycemia. To date, it is obvious that the development of prediabetes lead not only to the higher risk of diabetes mellitus in the future, but also of cardiovascular diseases. Factors that increase the risk of cardiovascular events in patients with prediabetes includeare the following: insulin resistance, accompanied by arterial hypertension and dyslipidemia, and postprandial hyperglycemia. Therefore, it is very important to timely identify patients from the risk group, diagnose and treat carbohydrate metabolism disorders already at the stage of prediabetes. Also it is very important to identify the patients from the risk group, diagnose and treat carbohydrate metabolism disorders at the stage of prediabetes. Treatment of patients with prediabetes implies, first of all, lifestyle modification (moderate hypocaloric nutrition with predominant restriction of fats and simple carbohydrates and regular physical activity of moderate intensity) in order to reduce weight. If lifestyle changes are ineffective, drug therapy may be prescribed. The article discusses the studies conducted to assess the effectiveness of lifestyle modification, as well as various options for antihyperglycemic therapy (metformin, glucagon-like peptide receptor agonists, alpha-glucosidase inhibitors, orlistat) for the treatment of patients with prediabetes. It also provides data on long-term follow-up of patients with prediabetes who received different treatment options. 

scholarly journals Pasireotide in an insulin-requiring diabetic acromegalic patient without worsening of hyperglycemia

2017 ◽  
Vol 2017 ◽  
Author(s):  
Murray B Gordon ◽  
Kellie L Spiller
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
List Type ◽  
Effective Treatment Option ◽  
Patients With Diabetes ◽  
Long Acting ◽  
Learning Points

Summary Long-acting pasireotide is an effective treatment option for acromegaly, but it is associated with hyperglycemia, which could impact its use in patients with diabetes. We present a case of a 53-year-old man with acromegaly and type 2 diabetes mellitus (glycated hemoglobin (HbA1c): 7.5%), who refused surgery to remove a pituitary macroadenoma and enrolled in a Phase 3 clinical trial comparing long-acting pasireotide and long-acting octreotide in acromegalic patients. The patient initially received octreotide, but insulin-like growth factor 1 (IGF-1) levels remained elevated after 12 months (383.9 ng/mL; 193.0 ng/mL; reference range: 86.5–223.8 ng/mL), indicating uncontrolled acromegaly. He switched to pasireotide 40 mg and subsequently increased to 60 mg. Within 6 months, IGF-1 levels normalized (193.0 ng/mL), and they were mostly normal for the next 62 months of treatment with pasireotide (median IGF-1: 190.7 ng/mL). Additionally, HbA1c levels remained similar to or lower than baseline levels (range, 6.7% to 7.8%) during treatment with pasireotide despite major changes to the patient’s antidiabetic regimen, which included insulin and metformin. Uncontrolled acromegaly can result in hyperglycemia due to an increase in insulin resistance. Despite having insulin-requiring type 2 diabetes, the patient presented here did not experience a long-term increase in HbA1c levels upon initiating pasireotide, likely because long-term control of acromegaly resulted in increased insulin sensitivity. This case highlights the utility of long-acting pasireotide to treat acromegaly in patients whose levels were uncontrolled after long-acting octreotide and who manage diabetes with insulin. Learning points Long-acting pasireotide provided adequate, long-term biochemical control of acromegaly in a patient with insulin-requiring type 2 diabetes mellitus who was unresponsive to long-acting octreotide. Glycemic levels initially increased after starting treatment with pasireotide but quickly stabilized as acromegaly became controlled. Long-acting pasireotide, along with an appropriate antidiabetic regimen, may be a suitable therapy for patients with acromegaly who also have insulin-requiring type 2 diabetes mellitus.

scholarly journals Improving Blood Pressure Control in Patients with Diabetes Mellitus and High Cardiovascular Risk

2010 ◽  
Vol 2010 ◽  
pp. 1-8 ◽  
Author(s):  
Henry L. Elliott ◽  
Suzanne M. Lloyd ◽  
Ian Ford ◽  
Peter A. Meredith
Keyword(s):  
Diabetes Mellitus ◽  
Pressure Control ◽  
Therapeutic Practice ◽  
Treatment Regimens ◽  
Channel Blocking ◽  
Patients With Diabetes ◽  
Symptomatic Coronary Artery Disease ◽  
Artery Disease ◽  
Long Acting ◽  
Very High

Patients with diabetes mellitus and symptomatic coronary artery disease are also likely to be hypertensive and, overall, are at very high cardiovascular (CV) risk. This paper reports the findings of a posthoc analysis of the 1113 patients with diabetes mellitus in the ACTION trial: ACTION itself showed that outcomes in patients with stable angina and hypertension were significantly improved when a long-acting calcium channel blocking drug (nifedipine GITS) was added to their treatment regimens. This further analysis of the ACTION database in those patients with diabetes has identified a number of practical therapeutic issues which are still relevant because of potential outcome benefits, particularly in relation to BP control. For example, despite background CV treatment and, specifically, despite the widespread use of ACE Inhibitor drugs, the addition of nifedipine GITS was associated with significant benefits: improvement in BP control by an average of 6/3 mmHg and significant improvements in outcome. In summary, this retrospective analysis has identified that the addition of nifedipine GITS resulted in improved BP control and significant outcome benefits in patients with diabetes who were at high CV risk. There is evidence to suggest that these findings are of direct relevance to current therapeutic practice.

scholarly journals RESULTS OF SURGICAL TREATMENT OF CALCANEAL FRACTURES IN PATIENTS WITH DIABETES MELLITUS

World Science ◽  
2019 ◽  
Vol 2 (4(44)) ◽  
pp. 4-6
Author(s):  
Kovalchuk P. Ye. ◽  
Gasko М. V. ◽  
Tulyulyuk S. V. ◽  
ShutkaV. J. ◽  
Bugai R. I.
Keyword(s):  
Diabetes Mellitus ◽  
Surgical Treatment ◽  
Treatment Results ◽  
Calcaneal Fractures ◽  
Emergency Rescue ◽  
Results Of Treatment ◽  
Patients With Diabetes ◽  
Inability To Work ◽  
Prevention Of Diabetes ◽  
Optical Transducer

One of the complicated problems of traumatology in the treatment of patients with calcaneal fractures is prevention of diabetes mellitus consequences. The work presents the analysis of treatment results of 72 patients with calcaneal fractures treated by means of surgical method at the Traumatological Adult Department, of the Regional Clinical Hospital “Emergency Rescue Hospital” (ERH), Chernivtsi, for the period from 2011 to 2018. With the purpose to examine the efficacy of treatment of calcaneal fractures all the patients were distributed into three clinical groups, patients with diabetes mellitus were isolated, and remote results of treatment were compared. Therefore, analysis of surgical treatment remote results of intra-articular calcaneal fractures in patients suffering from diabetes mellitus demonstrated that application of closed reposition under electrical optical transducer (EOT) control and fixation by means of wires leads to 44,38% improvement of treatment results, shortened terms of inability-to-work and disability.

scholarly journals Disturbances of carbohydrate metabolism and postoperative complications after distal pancreatic resection

2020 ◽  
Vol 37 (3) ◽  
pp. 33-39
Author(s):  
V. N. Barykov ◽  
A. G. Istomin ◽  
N. V. Markina ◽  
V. L. Tyulganova
Keyword(s):  
Diabetes Mellitus ◽  
Postoperative Complications ◽  
Carbohydrate Metabolism ◽  
Pancreatic Resection ◽  
Abdominal Cavity ◽  
The Body ◽  
Total Risk ◽  
Distal Pancreatic Resection ◽  
Before And After ◽  
Patients With Diabetes

Objective. To study the state of carbohydrate metabolism in patients after distal pancreatic resection and its effect on the development of postoperative complications. Materials and methods. Over 10 years, 47 patients have been operated on with various tumors of the body/tail of the pancreas and complications of chronic pancreatitis. In 16 of them, concomitant diabetes mellitus was diagnosed before surgery, and in 31 patients, carbohydrate metabolism was normal. Results. After surgery, from a group of patients with unchanged carbohydrate metabolism, 8 (25.8 %) developed diabetes mellitus. The following postoperative complications pancreatic fistula, inflammatory infiltrates and "fluid leakages in the abdominal cavity occurred in 68 % of cases. Out of 24 patients with diabetes mellitus, complications were registered in 21 (87.5 %) and of 23 diabetes-free patients in 11 (47.8 %). Conclusions. The total risk for the development of the postoperative abdominal complications after the distal resection in patients with diabetes mellitus, diagnosed before and after the intervention, is 7.6 times higher than in patients without diabetes.

scholarly journals Depressive disorders in patients with diabetes mellitus. The effect of sedariston phytopreparation on carbohydrate metabolism and psycho-emotional state of patients with anxiety-depressive syndrome

2021 ◽  
Vol 17 (7) ◽  
pp. 562-569
Author(s):  
S.M. Tkach ◽  
T.L. Miliutina
Keyword(s):  
Diabetes Mellitus ◽  
Carbohydrate Metabolism ◽  
Depressive Disorders ◽  
Emotional State ◽  
Glycated Hemoglobin ◽  
Depressive Syndrome ◽  
Control Group ◽  
Patients With Diabetes ◽  
Reactive Anxiety ◽  
Personal Anxiety

Background. Depressive disorders are quite common in patients with diabetes mellitus (DM). Depression is associated with worsening glycemic control. Attempts to improve it through the use of synthetic antidepressants in complex therapy have had mixed results. The study was aimed to evaluate the prevalence of depressive disorders in patients with diabetes mellitus treated in the endocrinology department and to evaluate the effect of combined herbal medicine Sedariston containing standardized extracts of Hypericum perforatum (100 mg) and Valeriana (50 mg) (Esparma GmbH, Germany) on carbohydrate metabolism and psycho-emotional state of diabetic patients with the anxiety-depressive syndrome. Materials and methods. The study included 122 patients with type 1 and 2 DM, 103 women and 19 men, aged 18 to 75 years. Thirty-three of them with anxiety-depressive syndrome participated in a 3-month study, 16 of which additionally received Sedariston 2 capsules twice a day for 2 months. Prior to, as well as 2 weeks, 1, 2, 3 months from the beginning of the observation, the psycho-emotional state was assessed with a determination of the severity of the depressive syndrome on the PHQ-9, Beck scales, as well as the state of personal and reactive anxiety on the Spielberger-Hanin’s scales. Glycated hemoglobin was determined before and 3 months after the start of monitoring. All patients received insulin therapy and/or hypoglycemic oral medications at constant doses during the observation. Results. Depressive disorders were identified in 80.3 and 67.2 %, respectively, according to the PHQ-9 and Beck scales. Most patients experienced mild and moderate depression. High personal anxiety was found in 66.4 %, high reactive anxiety in 50.8 % of patients. Patients in the Sedariston basic group reported significant improvement in depressive symptomatology with a decrease in PHQ-9 scores from 13.7 ± 1.6 to 9.3 ± 1.4 (p < 0.05) after 1 month of treatment, and on the Beck’s scale from 23.9 ± 1.8 to 18.2 ± 1.9 points (p < 0.05) after 2 months of treatment, in contrast to patients in the control group without Sedariston: 11.9 ± 1.2 and 10.8 ± 1.1 points (p > 0.1) on the PHQ-9 scale and 19.7 ± 1.7 and 18.9 ± 2.3 points (p > 0.1) on the Beck’s scale, respectively. The achieved improvement of the psycho-emotional state of patients after the end of treatment with Sedariston was maintained after 3 months from the beginning of monitoring: 7.1 ± 1.3 points on the PHQ-9 scale and 16.1 ± 2.1 points on the Beck’s scale (p < 0.01). After 2 months of Sedariston therapy in the group of patients with the anxiety-depressive syndrome, unlike the patients of the control group, personal anxiety decreased from 59.5 ± 2.2 to 53.5 ± 1.9 points on the Spielberger-Hanin’s scale (p < 0.05), in patients with high reactive anxiety, after 2 months of treatment significantly decreased its level from 57.4 ± 2.5 to 49.3 ± 2.7 points and remained so until the end of observation. Against the background of the positive dynamics of depressive symptoms in patients receiving Sedariston, a significant decrease in glycated hemoglobin occurred 3 months after the start of therapy: from 9.4 ± 0.5 to 8.1 ± 0.2 % (p < 0.05), unlike the patients of the control group. Conclusions. An anxiety-depressive syndrome is defined in 63.1 % of patients of the diabetology department, with depressive disorders mainly of mild and moderate severity, high personality and reactive anxiety, and 19.7 % of patients experienced a depressive syndrome without disturbance of anxiety, which indicates their diagnosis and conducting appropriate treatment. The combined phytopreparation Sedariston in the complex therapy of patients with diabetes mellitus, against the backdrop of the positive and long-lasting effect on anxiety-depressive symptoms, contributes to the improvement of carbohydrate metabolism, with a decrease of 1.3 % of glycated hemoglobin in 3 months. This indicates that Sedariston may be used not only for the treatment of anxiety-depressive syndrome but also to improve carbohydrate metabolism in patients with DM.

scholarly journals VITAMIN D AND DIABETES MELLITUS TYPE 2

2017 ◽  
Author(s):  
N. V. Pasyechko ◽  
V. M. Kulchinska ◽  
L. V. Radetska ◽  
L. V. Naumova ◽  
I. V. Smachylo ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Vitamin D ◽  
Carbohydrate Metabolism ◽  
Diabetes Mellitus Type 2 ◽  
Glycated Haemoglobin ◽  
Diabetes Mellitus Type ◽  
Control Group ◽  
Metabolic Disturbances ◽  
Patients With Diabetes

Background. As it is established that diabetes mellitus causes metabolic disturbances of all types (first of all because of carbohydrate metabolism), affection of blood vessels, nerves, different organs and tissues. However, the influence of DM on the level of microelements is still not investigated enough. Despite the sufficient variety of medicaments, compensation of diabetes mellitus is achieved in less than 30% of patients. For this reason, the search of new ways of treatment which are aimed at the improvement of carbohydrate metabolism is an urgent issue.Objective. The research was aimed to reveal the deficiency of 25-hydroxyvitamin D3 [25(OH)D3] and its correlation with carbohydrate metabolism.Materials and methods. Thirty five patients with diabetes mellitus Type 2 aged 55-74 with illness duration 2-4 years were examined. The control group included 35 healthy people of the same age and sex. Levels of 25-hydroxyvitamin D3 [25(OH)D3] were tested by means of radioimmunoassay. The level of glycated haemoglobin was tested by means of liquid chromatography.Results. Correlation of the level of vitamin D with the degree of diabetes mellitus Type 2 compensation has been detected.Conclusions. A clear tendency to the improvement of diabetes mellitus Type 2 compensation after medication correction with vitamin D was evidenced. 

scholarly journals Comparison of methods of automatic bipolar sealing and monopolar coagulation in the surgical treatment of hemorrhoids in patients with diabetes

2021 ◽  
pp. 47-52
Author(s):  
О. V. Ivanko ◽  
S. V. Skiba ◽  
Hassan Al-Lami Saad Humud ◽  
A. V. Goman ◽  
V. V. Lysytsia
Keyword(s):  
Diabetes Mellitus ◽  
Surgical Treatment ◽  
Daily Activity ◽  
Control Group ◽  
Study Group ◽  
Narcotic Analgesics ◽  
Traditional Methods ◽  
Normal Daily Activity ◽  
Patients With Diabetes ◽  
Surgery Duration

Comparison of LigaSure and traditional methods of surgical treatment of III and IV degree hemorrhoids in patients with diabetes mellitusHemorrhoids are submucosal nodules in the anal canal that contain venules, arterioles, and smooth muscle fibers. Hemorrhoidal disease is registered in approximately 5 % of the total population, especially after 40 years. Treatment is indicated only in symptomatic cases. These symptoms include pain, itching, bleeding, thrombosis and hemorrhoidal prolapse.Aim — to compare the clinical results of he­­mor­rhoidectomy using the electrocoagulation he­mostatic device LigaSure and the traditional Milligan—Morgan method in patients with diabetes mellitus. Materials and methods. The study included 65 patients of both genders aged 18—78 years with stage 3 and 4 hemorrhoids, who underwent hemor­rhoidec­tomy: from them, 33 subject were operated with LigaSure (the main group), and 32 patients with traditional Milligan—Morgan method (control group). The following patients’ data were analyzedretrospec­tively:gender, age, pre- and postoperative hemoglobin and hematocritlevels, surgery duration, the presence of thrombosis, the number of removed and residual hemorrhoids, hospitalization duration, early and late postoperative complications, the need for narcotic analgesics, the observationalperiod, and the time to return to normal daily activity. Results. The mean surgery duration was 16 (6—45) min in the study group and 21 (7—43) min in the control group. Narcotic analgesics in the postoperative period were used in 17 (53.1 %) patients in the control group and were not used in the study group. The timerequired for return to the normal daily activity was 6 (2—15) days in the study group and 8 (2—30) days in the control group. Conclusions. It has been shown that LigaSure gave betterresults of hemorrhoidectomy versus traditional methods in patients with diabetes mellitus in terms of surgery duration, hospitalizationperiod, postoperative pain relief needs, risk of postoperative bleeding, and time required to return to normal daily activity.

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